|Year : 1983 | Volume
| Issue : 5 | Page : 607-608
Disc changes and field changes in glaucoma (A correlative study)
Rajiv Khandekar, BM Khamar, SK Narang
Institute of Ophthalmology, Ahmedabad, India
Institute of Ophthalmology, Ahmedabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Khandekar R, Khamar B M, Narang S K. Disc changes and field changes in glaucoma (A correlative study). Indian J Ophthalmol 1983;31:607-8
| Methods and Materials|| |
In this study 50 eyes of 27 patients known cases of glaucoma or suspected cases of glaucoma were taken up. A thorough eye check-up was done of all the patients followed by field charting of each eye on Goldman's perimeter under standard conditions. Disc changes were noted after dilatation of pupils with the help of direct ophthalmoscope, slit lamp with Hurby's Lens i.e. binocular stereoscope examination. The disc changes were documented on diagrammetic disc and using fundus camera with black and white film.
(1) Early changes: Includes
i) Paracentral scotomma
ii) Barring of blind spot
iii) Enlargement of spot
iv) Seidel's sign
v) Peripheral construction
vi) Temporal or nasal step.
(2) Intermediate change: includes Arcuate scotoma
(Single or Ring)
(3) Late field changes: includes Marked construction of field with temporal island.
| Observations and Discussion|| |
Field changes were co-related with various disc parameter and results are as follows:
Early field changes:-Of all the mentioned early field changes paracentral scotoma is seen and is most important since it is rarely caused by other pathology.
In this study paracentral scotomas or various forms were found in 32 eyes with or without other field changes. The most common and frequent disc change noticed in all cases was bayonetting or notching of neuroretinal rim (28 out of 32 cases). This was seen in the form of irregularity at some particular site of cup extending never to the disc margin. The most frequent site was vertical meridian of the disc. The second most important disc change noticed was visible laminar dots in a localized corresponding area, found in 27 out of 32 cases. The importance of this finding lies in three cases in which bayoneting was not conspicous. In all these three cases visible laminar dots helped to suggest and co-relate field changes.
In one case only over-pass phenomenon was present as a diagnostic of disc changes in glaucoma.
Intermediate field changes
Arcuate scotomas represents more advanced stage of glaucoma and is believed to occur by aggregation of and enlargement of paracentral scotoma.
It was seen in a 9 cases in this study. The most common change associated of neuroretinal rim. (In all the cases 100%) and the notch was extending up to the disc margin in the vertical meridian. Another finding is uniform or uneven deep cup (In all cases) Laminar dots was visible in (6 cases only 66%).
Late field changes
Temporal island of vision with or without central island represent terminal stage of field
changes. This was seen in 8 cases-In all of them cup was deep with visible laminar dots in localised or generalised pattern. Disc was pale in all cases. Peripapillary halo was a constant feature. Neural rim was absent in atleast some sector of the disc.
| Summary|| |
Field changes as they are seen during various stages of glaucoma are co-related with the disc changes.